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Phosphaturic Tumor-Induced Osteomalacia
1Internal Medicine, University of California, Riverside, Riverside, USA.
Cureus
|February 23, 2024
Summary
Tumor-induced osteomalacia (TIO) is a rare bone disorder caused by tumors producing fibroblast growth factor-23. Early diagnosis and surgical removal of these tumors can effectively treat TIO and correct associated metabolic abnormalities.
Area of Science:
- Endocrinology
- Oncology
- Orthopedics
Background:
- Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome.
- It is characterized by skeletal abnormalities, osteopenia, and osteoporosis.
- Tumors producing fibroblast growth factor-23 (FGF23) are the primary cause.
Observation:
- Patients present with nonspecific symptoms, leading to diagnostic delays.
- Tumors can be located in bone or soft tissue, often in the lower extremities or spine.
- This case highlights an unusual presentation of TIO from a phosphaturic mesenchymal tumor in the left acetabulum.
Findings:
- FGF23 overproduction leads to renal phosphate wasting and impaired vitamin D activation.
- This results in hypophosphatemia and osteomalacia.
- Positron emission tomography (PET) scans aid in tumor localization and diagnosis.
Implications:
- Surgical resection is the primary treatment for TIO when feasible.
- Successful treatment can lead to symptom resolution and metabolic correction.
- Understanding TIO's diverse presentations is crucial for timely diagnosis and management.
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